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Sports and orthopaedic injury surgery

See an expert in Harrow and get an accurate diagnosis to speed your recovery

physiotherapist helping patient bend her knee on a hospital bed whilst wearing a knee support bandage
Regular exercise is very important and a key part of living a happy and healthy life. Unfortunately, when you regularly participate in exercise, even if it’s just for fun, you run the risk of suffering from injury.

Sports injuries are regularly referred to as orthopaedic injuries as they nearly always affect the musculoskeletal system — the complex structure of bones, muscles and connective tissues, such as tendons and ligaments, that are found in your body.

If you are suffering from a sports injury, or you have been diagnosed with another type of orthopaedic injury, our Harrow orthopaedic surgeons would be delighted to offer you their advice and support.

At The Clementine Churchill Hospital, we can offer you the attention you require at every stage, from diagnosis to treatment and beyond — helping you to get back on your feet and live life to the fullest as quickly as possible.

“Our aim is to always try and preserve your natural joints,” explains Mr Sherif El-Tawil, Consultant Orthopaedic Surgeon at The Clementine Churchill Hospital in Harrow.

There are many different sports and orthopaedic surgeries which could require surgery to help patients heal and get back to their previous levels of activity.

It would be impossible to list them all here, but here are some of the most common.

ACL tears

ACL tears are arguably one of the most common types of sports injuries, and very often require surgery. This is because ACL tears rarely heal themselves and can’t be stitched back together to repair them.

Instead, patients with ACL tears require reconstruction surgery, during which the old ACL is removed and replaced with a ligament that is harvested from your own, or in some cases, a donor hamstring.

ACL surgery is usually recommended for athletes, or for patients who will be looking to get back to moderate to high levels of physical activity. The goal is to restore stability and range of motion in the knee joint, so that patients can continue to take part in the activities that they enjoy. It is generally very low risk, although there is a considerable recovery period, and it could take patients up to a year before they can return to high-level sports.

Meniscus tears

Meniscus tears are another very prevalent knee injury, particularly in athletes and those who play contact sports. “Meniscus tears are easily the second most common knee injury that I see,” says Mr El-Tawil.

The meniscus is a c-shaped pad of cartilage in the knee. Its main purpose is to act as a shock absorber and absorb impact to protect the bones and other structures within the knee. There are two menisci, and it is the medial meniscus that is most commonly torn as a result of a traumatic injury, or due to degenerative changes that happen over time.

The trouble with a meniscus tear is that if you are under the age of 20, it is unlikely to heal itself, and so surgical intervention is needed to repair the knee. This is a minimally-invasive, arthroscopic (keyhole) surgery where the meniscus is repaired inside the knee, in a procedure sometimes referred to as an ‘all-inside repair’.

Rehabilitation time for a meniscus repair can take between three and six months.

Stress fracture

A stress fracture is an injury that normally forms part of a repetitive strain injury. This is because they tend to occur as a result of overuse.

When muscles get tired and weak, their ability to protect bones from impact is compromised. When these muscles and bones are then also subjected to the same type of impact over and over again, the bones can start to break. This is known as a stress fracture.

Some types of stress fractures need surgery to heal properly. In most instances, this involves using special equipment such as pins, screws or plates to support the bones in their new positions so that they can heal correctly. This is especially true in joints, which are more complicated than standard, single bones, making it more important that they heal perfectly.

Torn or detached rotator cuff

The shoulder has the widest range of motion of any joint in the human body. Unfortunately, this also makes it susceptible to injury.

The rotator cuff is a group of four muscles that come together as tendons to form a covering around the head of the humerus, which is the bone in the upper arm. The rotator cuff attaches the bone to the shoulder blade and facilitates movement. However, sudden movement, degeneration or impact can cause one or more of the rotator cuff tendons to tear or become detached from the bone. Athletes are particularly vulnerable to rotator cuff tears, particularly those that play sports like tennis or baseball.

Surgery for a torn or detached rotator cuff is usually recommended for athletes or people with moderate to heavily active lifestyles. The type of repair performed and your recovery period will depend on the size and position of the tear/detachment, and the quality of your tendon tissue and bone.

Osteochondral defects

Osteochondral defect is the term used to describe a focal area of damage that involves both cartilage and underlying bone. They are most often associated with injuries that occur during to repetitive strain.

However, some studies suggest that there may be a genetic link between patients with the condition. While they can affect any joint in the body, they are most often seen in the knee.

The most common osteochondral defect is where a small piece of articular cartilage covering the bone has come away. It may be floating around in the knee joint, in which case, a surgical technique called fixation is used to find and relocate the cartilage back to where it should be. This will preserve the joint and eliminate symptoms. If this fragment isn’t able to be found, there are other surgical options to treat the joint.

Patella dislocation and maltracking

The patella is the official name of the kneecap — the small, floating bone located at the very front of the knee.

In a healthy knee, the patella glides up and down within a groove at the bottom of the thigh bone when you move around. However, if the muscles that hold the patella in its correct position become weakened, it can cause instability that causes the patella to be pulled out of the groove and towards the outer side of the knee — known as a knee dislocation.

Patella stabilisation surgery, also known as patella realignment, is a common orthopaedic surgery to stabilise and realign the patella following dislocation and misalignment of the knee cap.

Just like many orthopaedic surgeries, it is followed by intense physiotherapy to help strengthen the muscles in and around the knee, maintain your range of motion and increase the overall success of the surgery.

Although you may certainly suffer from some symptoms, not all sports and orthopaedic injuries are immediately obvious. Your Clementine Churchill Hospital orthopaedic surgeon may conduct a number of different assessments to pinpoint the cause of your injury as accurately and quickly as possible.

In addition to a physical examination, which could include asking you to perform, or at least try to perform, certain movements, you may also be referred for x-rays.

X-rays may not show soft tissue injuries, but they will help reveal what is happening with your musculoskeletal system so that your orthopaedic surgeon can make a diagnosis and recommend the most appropriate treatment.

Exactly what is involved in your orthopaedic surgery for injury will depend on the type of injury you’ve sustained, its severity and the recommendations of your consultant orthopaedic surgeon.

As with any surgery, it’s important to be aware of what you should do in the weeks and days ahead of your procedure. Not only will this help you to feel better prepared (which, in turn, can help you feel less anxious, calmer and more in control) but it could even directly influence the outcome of your surgical procedure.

Exactly what you’ll be advised to do will depend on the type of surgery you are having. However, some of the general guidelines that your orthopaedic team may give you could include:

  • Temporarily ceasing certain medications
  • Stopping smoking, as smoking is proven to increase the risk of surgical complications and lengthen the time it takes to recover from surgery
  • Preparing your life to be as easy as possible afterwards. This could mean anything from organising childcare or support with school runs to stocking up the freezer with meals or setting up a sleeping area on the ground floor so that you don’t have to do the stairs right away
  • Staying active. Regular physical activity will help keep your muscles strong —something which is vital for a rapid recovery and will aid your long-term physical mobility as you get back on your feet again
  • Preparing yourself mentally for time away from certain physical activities. Some surgeries can mean that you need to take up to a year off of specific sports. For example, it can take anywhere up to a year to fully recover from ACL reconstruction

You’ll also be asked to attend a pre-operative appointment before your surgery.

This will involve a physical exam and general health check, and a member of your surgical team will speak to you about what to expect on the day of your surgery, and afterwards. They will also be able to answer any questions that you have.

Again, your recovery from surgery will primarily depend on the type of surgery you’ve had.

Where possible, most orthopaedic surgeries are performed arthroscopically. This is a minimally-invasive technique whereby several small incisions are made into the area. One is used to insert the arthroscope — a long, thin tube with a camera and light on the end that feeds back real-time images to a monitor in the operating room.

The second incision is used as an access point for tiny tools which are used to repair or reconstruct as necessary. Arthroscopic procedures generally cause less discomfort, less scarring, have less risk of complications and are easier to recover from.

After your surgery, your surgeon or surgical team will give you instructions to follow. These will include information about things like wound care, how long you need to take off of work, what medications you should take and how often you should take them, and when you can start moving around.

It’s crucial that you follow post-operative instructions exactly as described, as they are designed to minimise your risk of complications and help you to heal and recover as quickly as possible.

After any sort of sports or orthopaedic surgery, nearly all patients will be referred for physical therapy.

The role of physical therapy is to build and strengthen the muscles and improve your range of motion, so that you can get back to full function without any long-term adverse effects.

“Physical therapy is often just as important as the surgery itself,” explains Mr El-Tawil. “This is because the muscles have just as crucial a role in joint stability and proper movement”.

Physical therapy can involve a variety of treatments and techniques, and these can change over the course of your time receiving rehabilitation. Examples include:

  • Exercises and stretches
  • Electrical stimulation
  • Ultrasound
  • Massage
  • Heat/cold treatments

“It’s impossible to understate the importance of physical therapy,” states Mr El-Tawil, who encourages patients to get back on their feet as soon as possible. “In fact, it is just as important as the surgery itself. Without it, the procedure would be ineffective”.

It is essential that you attend all appointments recommended by your orthopaedic surgeon. “Unfortunately, there’s no shortcut to getting back to the sports you enjoy. Regular PT will support your recovery and help make sure that you can return to your previous level of activity,” reassures Mr El-Tawil.

In some cases, your orthopaedic consultant may recommend regenerative treatments to help repair or replace damaged cartilage, tendons or ligament tissue that have occurred during a sporting injury.

Regenerative medicines refer to the use of biological tissues found in the human body, such as blood, fat or bone marrow. One of the most commonly-used regenerative medicines used in orthopaedics is platelet-rich plasma therapy.

Platelet-rich plasma therapy

Also known as PRP, platelet-rich plasma therapy is a fairly new regenerative treatment.

In PRP, a concentrated mixture of platelets from your own blood is used to help ease pain and accelerate the healing process in patients with sports and orthopaedic injuries. It’s able to do this because platelets are rich in proteins known as growth factors, which are proven to help cell regeneration and healing.

It can be used as a treatment in its own right, as well as during certain types of surgery to help tissues heal.

Whether you are a professional athlete or you just take part in sports for fun, you may be wondering if there is anything that you can do to avoid being injured.

Unfortunately, the reality is that if you have a potential weakness anywhere in your musculoskeletal system, there is very little that you can do to prevent an injury, particularly when it involves a joint like the knee.

Warming up properly before exercise and stretching after can help reduce your risk of suffering an injury, but ultimately, if one is going to occur, it’s going to be inevitable.

Sports and orthopaedic injuries are very common. If you are unlucky enough to suffer from one, the orthopaedic team at The Clementine Churchill Hospital, Harrow, can help you to get back on your feet and living life to the fullest again as quickly as possible.

For more information and advice about sports and orthopaedic injuries, diagnosis and treatment, you can speak to our friendly team on 020 8872 3872 or book your appointment online today.

Specialists offering Sports and orthopaedic injury surgery

Mr Tariq Zaman

Consultant Orthopaedic Surgeon

MBChB, FRCS (Orth)

The Clementine Churchill Hospital

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Dr Wolfgang Muller

Consultant Paediatrician

MRCP, FRCPCH

The Clementine Churchill Hospital

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